Skip Navigation

Strengthen the Evidence for Maternal and Child Health Programs

Sign up for MCHalert eNewsletter

Evidence Tools
MCHbest. Medical Home: Referrals.

MCHbest Logo

Strategy. Screening, Brief Intervention, and Referral to Treatment (SBIRT)

Approach. Facilitate screening, intervention, and referral services that connect community care networks and school based providers with medical centers and treatment facilities to ensure that patients with both critical and long-term medical and mental health needs have access to care.

Return to main MCHbest page >>

Overview. SBIRT screening can lead to significant increases in patient care, ensuring that patients with both critical and long-term medical and mental health needs have access to care. Implementing an electronic medical record. (EMR) tool to improve SBIRT screening compliance among pediatric inpatients, resulted in an increase from 0% to 34.4%, without a rise in positivity rates, while also revealing demographic differences in intervention rates.[1]

Evidence. Emerging Evidence. Strategies based on emerging evidence show promise but have not undergone extensive testing. While these approaches demonstrate potential, their effectiveness remains unconfirmed. Prioritize rigorous monitoring to ensure they achieve desired outcomes for all MCH populations.

Access the peer-reviewed evidence through the MCH Digital Library or related evidence source.

Potential Data Sources. Data to support this strategy can be accessed through:

  • Community-based organization service utilization data
  • Provider-to-provider communication records
  • Program capacity data

Outcome Components. This strategy has shown to have impact on the following outcomes (Read more about these categories):

  • Health and Health Behaviors/Behavior Change. This strategy improves individuals' physical and mental health and their adoption of healthy behaviors (e.g., healthy eating, physical activity).
  • Access to/Receipt of Care. This strategy increases the ability for individuals to obtain healthcare services when needed, including preventive, diagnostic, and treatment services.

Detailed Outcomes. For specific outcomes related to each study supporting this strategy, access the peer-reviewed evidence and read the Intervention Results for each study.

Intervention Type. Screening (Read more about intervention types and levels as defined by the Public Health Intervention Wheel).

Intervention Level. Community-Focused

Examples from the Field. There are currently no ESMs that use this strategy. Search similar intervention components in the ESM database.

Sample ESMs. Here are sample ESMs to use as models for your own measures using the RBA framework (see The Role of Title V in Adapting Strategies).

Quadrant 1:
Measuring Quantity of Effort (“What/how much did we do?”)

  • Number of community care networks, school-based providers, medical centers, and treatment facilities implementing SBIRT protocols. (Measures adoption of SBIRT approach)
  • Number of patients screened for medical and mental health needs using standardized SBIRT tools across settings. (Assesses reach of SBIRT screening efforts)

Quadrant 2:
Measuring Quality of Effort (“How well did we do it?”)

  • Percent of community care networks, school-based providers, medical centers, and treatment facilities implementing SBIRT protocols. (Measures adoption of SBIRT approach)
  • Percent of patients screened for medical and mental health needs using standardized SBIRT tools across settings. (Assesses reach of SBIRT screening efforts)

Quadrant 3:
Measuring Quantity of Effect (“Is anyone better off?”)

  • Number of cross-sector partnerships established to support seamless delivery of SBIRT services that report high levels of engagement. (Measures care coordination infrastructure)
  • Number of policies and payment models promoted by Title V that support sustainable implementation of SBIRT programs. (Assesses enabling conditions for SBIRT)
  • Number of communities experiencing improved access and care quality through widespread adoption of SBIRT models. (Measures population health impact)
  • Number of health professional education programs integrating SBIRT competencies as core expectations. (Shows influence on workforce development)

Quadrant 4:
Measuring Quality of Effect (“How are they better off?”)

  • Percent of SBIRT initiatives designed with active input from patients and communities that report high levels of engagement. (Measures community engagement in SBIRT efforts)
  • Percent of SBIRT programs allocating resources to prioritize the needs of the community. (Assesses reach in SBIRT implementation)
  • Percent of communities experiencing improved access and care quality through widespread adoption of SBIRT models. (Measures population health impact)
  • Percent of health professional education programs integrating SBIRT competencies as core expectations. (Shows influence on workforce development)

Note. When looking at your ESMs, SPMs, or other strategies:

  1. Move from measuring quantity to quality.
  2. Move from measuring effort to effect.
  3. Quadrant 1 strategies should be used sparingly, when no other data exists.
  4. The most effective measurement combines strategies in all levels, with most in Quadrants 2 and 4.

Learn More. Read how to create stronger ESMs and how to measure ESM impact more meaningfully through Results-Based Accountability.

References

[1] Roubil, J. G., Hazeltine, M. D., Bludevich, B. M., Aidlen, J. T., Pustis, N., Ferrante, C., Hirsh, M. P., & Cleary, M. A. (2022). Assessing screening, brief intervention, and referral to treatment (SBIRT) compliance and differences for pediatric inpatients at a tertiary care facility. Journal of pediatric surgery, 57(1), 111–116. https://doi.org/10.1016/j.jpedsurg.2021.09.048

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U02MC31613, MCH Advanced Education Policy, $3.5 M. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.